The use of the natural sea sponge as a catamenial device.

The purpose of this study was to obtain information regarding the safety of natural sea sponges as catamenial devices. Because of the recent association of menses, tampon use, and staphylococcal infection with toxic shock syndrome, this study assessed the association of catamenial use with changes in vaginal flora. Eighty-three healthy menstruating women participated by completing a confidential questionnaire and allowing the collection of cervical os cultures at mid-cycle and menses. Fifty-eight women used tampons and 25 used sea sponges. Tampons and sea sponges were also cultured. The demographic data revealed that the groups were matched with regards to age, race and parity. The yearly household incomes of the tampon users were slightly higher than the sponge users' incomes. Staphylococcal colonization was found to increase during menses in both groups. When cultured during menses, sea sponge users were found to have significantly higher colonization rates with Staphylococcus aureus, E. coli, and other enterobacteriacaeae. Cultures from tampon and sea sponges revealed similar results. The association of sea sponges with increased Staphylococcus aureus colonization suggests that they are not an attractive alternative to tampons in women seeking to decrease the rick of toxic shock syndrome.